The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on February 4, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln014
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Concern About Falls Elicits Changes in Gait Parameters in Conditions of Postural Threat in Older People
1 Falls and Balance Research Group, Prince of Wales Medical Research Institute, University of New South Wales, Randwick, Sydney, Australia
2 Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences and
3 Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium
Address correspondence to Kim Delbaere, PhD, Prince of Wales Medical Research Institute, PO Box 82, Randwick 2031 NSW, Australia. Email: k.delbaere{at}powmri.au
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Abstract |
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Background.: Previous studies have indicated that gait patterns in older people may be affected by concern about falling. The aim of this study was to examine the effects of concern about falling and physiological falls risk on gait performance using a paradigm in which concern about falling was experimentally induced.
Methods.: Forty-four community-living older adults (17 men, 27 women) with a mean age of 76.8 (standard deviation = 5.2) years walked at self-selected speeds on the floor and on a 60-cm elevated walkway in normal and dim lighting conditions. Temporal and spatial gait parameters, muscle activity, measures of physiological arousal, physiological falls risk, and concern about falls were assessed.
Results.: Physiological falls risk was associated with slower walking speeds in all conditions including the optimal (floor) condition (p = .029). In the elevated walkway conditions, concern about falls (both self-report and as indicated by physiological arousal) was increased and participants walked more slowly, took shorter steps, decreased their cadence, and spent more time in double support (p < .005). Disproportionately large reductions in walking speed were evident in participants with greater concern about falling (p = .018).
Conclusions.: These findings suggest that walking performance is influenced by both physiological and psychological factors. Physiological falls risk appears to determine walking speed under optimal conditions, whereas concern about falling elicits greater (possibly excessive) gait adjustments under conditions of postural threat.
Keywords Fear of falling; Aging; Elderly; Walking; Behavior
Received: November 28, 2007; Accepted: May 10, 2008